| NPI | 1801383898 |
|---|---|
| Former Name | SHAMUEL MEYEROVICH YAGUDAYEV |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MO 2022025508) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY P10041) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2022-07-22 |