NPI | 1558518415 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM T. WALLENS Physician Owner 716-298-4330 |
Organization Subpart ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 116615) |
Enumeration Date | 2008-08-22 |
Last Update Date | 2013-06-11 |