| NPI | 1982441887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALLORY EDWARDS Director Of Clinical Operations 716-574-3828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Enumeration Date | 2024-07-09 |
| Last Update Date | 2024-07-11 |