| NPI | 1861715161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 20053342) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MA PH232520) |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2011-09-21 |