| NPI | 1619386612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NJ 28ri03423100) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53028) |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2025-08-19 |