Individual
ALI ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1900 W LAYTON AVE APT 212, MILWAUKEE, WI 53221-5320
(216) 502-7053
Mailing address
2700 N GRANDVIEW BLVD, WAUKESHA, WI 53188-1611
(262) 542-2003
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20042-40
WI
Other
Enumeration date
02/12/2021
Last updated
02/12/2021
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