| NPI | 1144513813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEONID KOL Owner 718-850-6345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F304465) |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2011-05-27 |