| NPI | 1912784091 |
|---|---|
| Doing Business As | REVENANT INTERNATIONAL LLC |
| Entity Type | Organization |
| Authorized Contact | TREVOR JONES Authorized Official 718-717-8121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-12 |