NPI | 1467872143 |
---|---|
Former Name | JEFFREY MICHAEL MAGUIRE |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: KY TP909) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 60) |
207Q00000X Family Medicine (Licence: AZ 007390) | |
Enumeration Date | 2014-04-22 |
Last Update Date | 2023-11-29 |