| NPI | 1639422843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61189972) |
| Additional Taxonomies | 124Q00000X Dental Hygienist (Licence: OR H5388) |
| Enumeration Date | 2012-10-25 |
| Last Update Date | 2022-11-08 |