| NPI | 1760669402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 045999) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 20630) |
| 174400000X Specialist (Licence: NY 18604) | |
| Enumeration Date | 2008-01-24 |
| Last Update Date | 2009-12-10 |