| NPI | 1588835821 |
|---|---|
| Former Name | LYDIA SUZANNE STICKNEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 300570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 047390) |
| Enumeration Date | 2008-03-14 |
| Last Update Date | 2021-11-01 |