| NPI | 1770822702 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: RI RPH04678)  | 
| Additional Taxonomies | 1835N1003X Pharmacist, Nutrition Support (Licence: RI RPH04678)  | 
| Enumeration Date | 2013-02-12 | 
| Last Update Date | 2013-02-12 |