| 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 |