| NPI | 1659482750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03219297) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302031244) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-03-21 |