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1164005526
WISAM AL-MUTAWALLI
SYRACUSE, NY
NPI
1164005526
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-05-04
Last Update Date
2021-05-04
Business Address
WISAM AL-MUTAWALLI MD
750 E ADAMS ST
SYRACUSE, NY 13210-2306
Phone number: 978-221-1081
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Mailing Address
WISAM AL-MUTAWALLI MD
750 E ADAMS ST
SYRACUSE, NY 13210-2306
Phone number:
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