| NPI | 1669673349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORY SHAFFER Director 716-893-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 333122) |
| Enumeration Date | 2007-05-30 |
| Last Update Date | 2022-05-09 |