| NPI | 1497392476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OK 12549) |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy |
| Enumeration Date | 2019-12-09 |
| Last Update Date | 2019-12-09 |