| NPI | 1912335472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: TX 54325) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03119119) |
| Enumeration Date | 2013-10-21 |
| Last Update Date | 2014-08-29 |