| NPI | 1811457534 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH60913098)  | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302041975)  | 
| 183500000X Pharmacist (Licence: CA 76377)  | |
| Enumeration Date | 2019-03-20 | 
| Last Update Date | 2019-10-15 |