NPI | 1699742288 |
---|---|
Former Name | FRED AST |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NY 1783111) |
Additional Taxonomies | 207K00000X Allergy & Immunology (Licence: NY 1783111) |
207R00000X Internal Medicine (Licence: NY 1783111) | |
Enumeration Date | 2006-03-02 |
Last Update Date | 2022-08-22 |