| NPI | 1851764740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTO LICIER Pharmacist 410-918-0790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: MD 10970) |
| Enumeration Date | 2015-11-02 |
| Last Update Date | 2015-11-02 |