Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 174V00000X | Clinical Ethicist |
NPI | 1730584376 |
---|---|
Provider Name | Mr. Antonio Lowe |
First Address | New York, NY 10018-6504 |
Second Address | Brooklyn, NY 11201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2014 |
Last Update Date | 24/10/2014 |