| NPI | 1750864971 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY I063957) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: PA RP451108) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: VA 0202215328) | |
| Enumeration Date | 2018-09-13 |
| Last Update Date | 2018-09-13 |