| NPI | 1891189783 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 183500000X Pharmacist (Licence: CO 20347) | 
| Additional Taxonomies | 183500000X Pharmacist (Licence: WY 3746) | 
| Enumeration Date | 2015-03-27 | 
| Last Update Date | 2019-01-09 |