| NPI | 1669757993 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60077200) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 15258-40) |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2011-10-18 |