| NPI | 1144547837 |
|---|---|
| Former Name | ERIC NICHOLAS SHAMO |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OR MD156656) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-04-21 |
| Last Update Date | 2018-05-30 |