| NPI | 1912536509 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE RICARDO TRIGUEROS Fellow 718-200-7834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2020-04-06 |
| Last Update Date | 2020-04-06 |