| NPI | 1457363400 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60266311) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 13141) |
| 183500000X Pharmacist (Licence: NM 4620) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-11-13 |