| NPI | 1750499695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: MN 119384) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 20357) |
| 183500000X Pharmacist (Licence: NE 12510) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2025-01-21 |