| NPI | 1659772796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 061830) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH235222) |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2022-10-03 |