| NPI | 1811279706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANTHAKHONE DOUANGDARA Pharmacist 305-254-0323 |
| Organization Subpart ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: FL PS42653) |
| Enumeration Date | 2011-09-15 |
| Last Update Date | 2011-09-15 |