NPI | 1801945043 |
---|---|
Other Name | J. RUSSEELL BOWEN |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME162623) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NE 20839) |
Enumeration Date | 2007-01-09 |
Last Update Date | 2023-07-31 |