| NPI | 1912289877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: OH 03122725) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: MI 5302032833) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |