| NPI | 1639627896 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 062261) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0122195) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |