| NPI | 1043247828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WM0705X Registered Nurse, Medical-Surgical (Licence: ME RN 52296) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: ME RN 52296) |
| 163WH0200X Registered Nurse, Home Health (Licence: ME RN 52296) | |
| 163WG0600X Registered Nurse, Gerontology (Licence: ME RN 52296) | |
| 163WG0000X Registered Nurse, General Practice (Licence: ME RN 52296) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2009-01-06 |