| NPI | 1780805861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH00059419) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NM RP00006224) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2007-07-08 |