| NPI | 1164133039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN LAVANDERA RODRIGUEZ Authorized Official 716-423-3042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2022-12-12 |
| Last Update Date | 2022-12-12 |