| NPI | 1679842363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL ps44746) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 052770) |
| Enumeration Date | 2011-12-24 |
| Last Update Date | 2014-03-31 |