| NPI | 1710222179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60306294) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: HI 3077) |
| 183500000X Pharmacist (Licence: FL 47022) | |
| Enumeration Date | 2012-12-11 |
| Last Update Date | 2013-02-26 |