NPI | 1235134149 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID P KOWALSKI Owner 716-677-3065 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY 204975) |
Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: NY 008329) |
Enumeration Date | 2005-06-16 |
Last Update Date | 2013-01-08 |