| NPI | 1609245174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: UT 9496739-1701) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 121549) |
| Enumeration Date | 2015-09-15 |
| Last Update Date | 2015-09-15 |