| NPI | 1407040280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN ELIZABETH BRUNO Manager 716-945-2825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F303946 1) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2008-06-19 |