| NPI | 1710287578 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 364SP0810X Clinical Nurse Specialist, Psych/Mental Health, Child & Family (Licence: MA RN279047) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 279047) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MA 279047) | |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2023-12-05 |