NPI | 1285003459 |
---|---|
Entity Type | Organization |
Authorized Contact | CHARLES W BURNS Primary Provider 716-266-6664 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 332858) |
Enumeration Date | 2015-09-17 |
Last Update Date | 2015-12-22 |