| NPI | 1407138423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH21586) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: RI RPH03477) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |