| NPI | 1093826661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ME CNP81406) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME CNP81406) |
| 363LF0000X Nurse Practitioner, Family (Licence: ME R039768) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-03-11 |