| NPI | 1356234538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: ME CNP241775) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME RN65387) |
| Enumeration Date | 2025-05-29 |
| Last Update Date | 2025-07-22 |