NPI | 1114079639 |
---|---|
Entity Type | Organization |
Authorized Contact | HEATHER MCKENZIE Office Manager 585-424-6770 |
Organization Subpart ? | No |
Primary Taxonomy | 174400000X Specialist (Licence: NY 197921-1) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 120151-1) |
174400000X Specialist (Licence: NY 230724) | |
363L00000X Nurse Practitioner (Licence: NY 33554) | |
Enumeration Date | 2007-01-17 |
Last Update Date | 2008-09-09 |