| NPI | 1982088761 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: NY 060516) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: CT 0013035) |
| Enumeration Date | 2015-07-12 |
| Last Update Date | 2015-12-21 |