| NPI | 1861610040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IA 15431) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: IA 15431) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2025-09-11 |