| NPI | 1902027980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: NY 028273) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 044138) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2007-08-14 |