Individual
ESRA AHHMED MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
125 E LONG LAKE RD, TROY, MI 48085-5524
(248) 879-9114
Mailing address
125 E LONG LAKE RD, TROY, MI 48085-5524
(248) 879-9114
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5302043793
MI
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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