| NPI | 1811989239 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03-1-24347) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0006442) |
| Enumeration Date | 2005-08-22 |
| Last Update Date | 2014-10-21 |