| NPI | 1619387990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: SC 12454) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: NC 20256) |
| 1835G0303X Pharmacist, Geriatric (Licence: TN 8485) | |
| Enumeration Date | 2014-05-07 |
| Last Update Date | 2014-05-07 |