Individual
BITA NGWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
15100 BALTIMORE AVE # 1790, LAUREL, MD 20707
(301) 776-5404
Mailing address
15100 BALTIMORE AVE # 1790, LAUREL, MD 20707-4602
(301) 766-5404
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
21958
MD
183500000X
Pharmacist
PR12629
ME
Other
Enumeration date
11/03/2012
Last updated
08/31/2018
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