| NPI | 1689141137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00010257) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP00000125) |
| Enumeration Date | 2018-11-01 |
| Last Update Date | 2018-11-01 |