| NPI | 1679018618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60665716) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202212593) |
| Enumeration Date | 2016-12-29 |
| Last Update Date | 2016-12-29 |