| NPI | 1720342611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 056771) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302413372) |
| Enumeration Date | 2012-06-26 |
| Last Update Date | 2026-05-22 |