| NPI | 1194138750 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IBRAHIMA NGOM Pharmacy Manger 810-235-6363 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MI 5302040683) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: OH 03331105) |
| Enumeration Date | 2014-06-11 |
| Last Update Date | 2014-06-11 |