| NPI | 1639417504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1300X Pharmacist, Psychiatric (Licence: MO 2006011639) |
| Additional Taxonomies | 1835G0303X Pharmacist, Geriatric (Licence: MO 2006011639) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-01-28 |