| 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 |