| NPI | 1912107921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WY 2508) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CO 12877) |
| 183500000X Pharmacist (Licence: UT 56840651701) | |
| Enumeration Date | 2007-07-19 |
| Last Update Date | 2007-07-19 |