| NPI | 1619292992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 0489711) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 048971) |
| 183500000X Pharmacist (Licence: MD 16089) | |
| 183500000X Pharmacist (Licence: PA rp046420) | |
| 207Q00000X Family Medicine (Licence: MI 4301096280) | |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2022-04-12 |