| NPI | 1770860462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61359766) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: KY 014506) |
| 183500000X Pharmacist (Licence: OH 03-1-27334) | |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2026-05-27 |