| NPI | 1609208586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 062865) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 12169) |
| 183500000X Pharmacist (Licence: NC 22405) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2021-01-13 |