| NPI | 1912314196 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 065315) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: VT 033.0088199) |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2019-10-11 |