| NPI | 1568099075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202209640) |
| Additional Taxonomies | 3336M0003X Pharmacy, Managed Care Organization Pharmacy (Licence: VA 0202209640) |
| Enumeration Date | 2020-03-25 |
| Last Update Date | 2020-03-25 |