| NPI | 1780966960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH23484) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NV 15647) |
| Enumeration Date | 2011-09-14 |
| Last Update Date | 2011-09-14 |