| NPI | 1487628970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-3-13455) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302024014) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2007-07-27 |