| NPI | 1588870539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PR 6977) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: PR 1373) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2021-12-10 |