| NPI | 1649551763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03311695) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302040656) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2011-09-01 |