| NPI | 1639382922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME73994) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: FL PS23838) |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2015-12-22 |