Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 3401 | NH |
NPI | 1982672861 |
---|---|
Provider Name | John T Bowman |
First Address | Boca Raton, FL 33486-2335 |
Second Address | Boca Raton, FL 33486-2335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 16/07/2009 |