| NPI | 1790181741 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: VA 0202207888)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0007091)  | 
| Enumeration Date | 2014-11-18 | 
| Last Update Date | 2014-11-18 |