| NPI | 1619250859 |
|---|---|
| Former Name | ERIC BEAN |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201403722NP-PP) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA RN2262812) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2262812) | |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2014-08-08 |