| NPI | 1962708594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT PCT.0011175) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 055397-1) |
| Enumeration Date | 2011-01-30 |
| Last Update Date | 2011-01-30 |