Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | X011772 | NY |
NPI | 1477762854 |
---|---|
Provider Name | Dr. David Michael Florance |
First Address | Windsor, NY 13865-4131 |
Second Address | Windsor, NY 13865-4131 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/05/2007 |
Last Update Date | 22/06/2011 |