| NPI | 1427619394 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WASIHUN BERHE NICODIMOS Clinical Pharmacist, Hiv Pharmacist 505-402-7990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy |
| Additional Taxonomies | 183500000X Pharmacist |
| Enumeration Date | 2019-06-21 |
| Last Update Date | 2021-10-01 |