| NPI | 1639588999 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60938240) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 54520) |
| Enumeration Date | 2014-08-11 |
| Last Update Date | 2021-04-29 |