| NPI | 1790124816 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: OK 13769) |
| Additional Taxonomies | 1835P1200X Pharmacist, Pharmacotherapy (Licence: TX 44497) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2016-07-18 |