| NPI | 1861833139 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MA PH235128) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: TX 53047) |
| Enumeration Date | 2013-07-15 |
| Last Update Date | 2014-08-01 |