| NPI | 1992340129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: WA PH61025934) |
| Additional Taxonomies | 333600000X Pharmacy (Licence: WA IR60991386) |
| 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA PH61025934) | |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2020-08-19 |