| NPI | 1790052280 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60222928) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR RPH-0012845) |
| Enumeration Date | 2011-11-28 |
| Last Update Date | 2011-12-02 |