| NPI | 1053111948 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH FISHBECK Board Secretary 315-265-3105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RH0002X Internal Medicine, Hospice and Palliative Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-03-18 |
| Last Update Date | 2025-03-18 |