| NPI | 1346636065 |
|---|---|
| Former Name | BEN TANNENBAUM |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME140566) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: OR MD180677) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2015-04-09 |
| Last Update Date | 2019-06-13 |