| NPI | 1710491568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FABIANE DE SOUZA Enrollment & Credentialing COO Rd. 646-962-2543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PT0002X Emergency Medicine Medical Toxicology |
| Enumeration Date | 2017-11-30 |
| Last Update Date | 2017-11-30 |