Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 5031 | NH |
Y | 208000000X | Pediatrician | 5031 | NH |
NPI | 1497778120 |
---|---|
Provider Name | Dr. Jon Michael Brian Vore SR. |
First Address | Nashua, NH 03060-2928 |
Second Address | Nashua, NH 03060-2928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 21/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200 | (05) | NH |
E17067 | (02) |