| NPI | 1104250851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EFREN F WU Owner 646-753-0121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: CA A121278) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2020-03-04 |