| NPI | 1376354159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER ERIK BOWEN Owner 718-362-1411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-04-15 |