| NPI | 1164865911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRINA DYNOV Nurse Practitioner 718-667-3577 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 33337627) |
| Enumeration Date | 2013-04-11 |
| Last Update Date | 2013-04-11 |