| NPI | 1902921216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA ph00049028) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 9420) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2012-09-06 |