| NPI | 1891560918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTTO SHILL Owner 347-688-6484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine |
| 204D00000X Neuromusculoskeletal Medicine & OMM | |
| Enumeration Date | 2023-11-20 |
| Last Update Date | 2023-11-20 |