| NPI | 1598944209 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WP0809X Registered Nurse Psychiatric/Mental Health, Adult (Licence: ME CNP81877) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ME RN35503) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2017-03-21 |