| NPI | 1972028801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA 60772539) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OR 0016078) |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2022-07-21 |