| NPI | 1194250456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINA WHYTE Business Administrator 929-990-3961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 7110511) |
| Enumeration Date | 2017-04-25 |
| Last Update Date | 2017-04-25 |