| NPI | 1710336623 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1835P2201X Pharmacist Ambulatory Care (Licence: MN 122815) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MN 122815) |
| 1835P2201X Pharmacist Ambulatory Care (Licence: WI 19601-875) | |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2023-11-14 |