NPI | 1255082335 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: ME CNP211415) |
Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: ME CNP211415) |
Enumeration Date | 2022-01-11 |
Last Update Date | 2025-03-26 |