| NPI | 1992124440 |
|---|---|
| Former Name | HEATHER LYDECKER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 288192) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NY 442507531) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2025-05-28 |