| NPI | 1912543299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1835P2201X Pharmacist, Ambulatory Care (Licence: UT 153044-1701) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: UT 153044-1701) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2019-11-21 |