| NPI | 1750169538 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WE0003X Registered Nurse, Emergency (Licence: ME 68085) |
| Additional Taxonomies | 163WP0808X Registered Nurse, Psych/Mental Health (Licence: ME 68085) |
| Enumeration Date | 2023-09-21 |
| Last Update Date | 2023-09-21 |