| NPI | 1740555960 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: MN 116066)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: WI 13338-40)  | 
| 183500000X Pharmacist (Licence: IA 20307)  | |
| Enumeration Date | 2012-03-21 | 
| Last Update Date | 2015-10-30 |