Individual
GONZALVES NTWALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
711 BROAD ST, PROVIDENCE, RI 02907-1481
(401) 331-9550
Mailing address
7 ARK CT, PROVIDENCE, RI 02908-3207
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH05152
RI
Other
Enumeration date
11/02/2012
Last updated
11/02/2012
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