| NPI | 1770836041 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 057306) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VA 0202211622) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2012-10-23 |