| NPI | 1558796763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: WV RP0009536) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS51150) |
| Enumeration Date | 2013-09-06 |
| Last Update Date | 2016-08-03 |