| NPI | 1508117581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: KY 010204) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03217777) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2013-11-15 |