| NPI | 1619394590 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 23687)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: MT 5560)  | 
| 183500000X Pharmacist (Licence: WY 3034)  | |
| 183500000X Pharmacist (Licence: FL 38734)  | |
| Enumeration Date | 2014-03-28 | 
| Last Update Date | 2014-03-28 |