| NPI | 1558342477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD J VANGORDER Consultant 607-737-1509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine, Nephrology |
| Additional Taxonomies | 207Y00000X Otolaryngology |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2020-08-22 |