| NPI | 1972152445 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: PA RP453798) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: WV RP0011657) |
| Enumeration Date | 2019-09-08 |
| Last Update Date | 2022-09-01 |