| NPI | 1962833772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: CT 0013468) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: NY 058324) |
| Enumeration Date | 2013-12-04 |
| Last Update Date | 2023-04-03 |