| NPI | 1033428958 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE ANN PRINCE COO 315-376-5246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208600000X Surgery | |
| Enumeration Date | 2010-09-27 |
| Last Update Date | 2018-11-27 |