Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0129X | Vascular Surgeon | A-2121-18 | NM |
NPI | 1093022402 |
---|---|
Provider Name | Robert Moskowitz |
First Address | Albuquerque, NM 87125-6666 |
Second Address | Albuquerque, NM 87106 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2010 |
Last Update Date | 11/06/2018 |