| NPI | 1700637378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIA PRONINA Resident 607-834-0028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2024-04-01 |
| Last Update Date | 2024-04-01 |