| NPI | 1679306302 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MN 126647)  | 
| Additional Taxonomies | 1835P2201X Pharmacist, Ambulatory Care (Licence: WI 22772-40)  | 
| Enumeration Date | 2024-08-20 | 
| Last Update Date | 2024-08-20 |