| NPI | 1467764001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP445566) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 21150) |
| Enumeration Date | 2010-07-12 |
| Last Update Date | 2011-11-03 |