| NPI | 1558368654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 045974) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 045974) |
| 1835P1200X Pharmacist, Pharmacotherapy (Licence: NY 045974) | |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2025-09-11 |