| NPI | 1831603679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P0018X Pharmacist Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist (Licence: MI 5302046867) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NC 27834) |
| 2255A2300X Specialist/Technologist Athletic Trainer (Licence: MI 5302046867) | |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2020-01-20 |