NPI | 1194797159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: ME AP081487) |
Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ME 038298) |
363LA2100X Nurse Practitioner, Acute Care (Licence: ME cnp81487) | |
363LF0000X Nurse Practitioner, Family (Licence: ME cnp81487) | |
Enumeration Date | 2006-02-03 |
Last Update Date | 2021-12-28 |