| NPI | 1902193899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: ID P5195) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WA 67848) |
| Enumeration Date | 2011-06-29 |
| Last Update Date | 2014-09-07 |