| NPI | 1972853299 |
|---|---|
| Other Name | PETER R BOURQUE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY F402626) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 525838) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2026-01-31 |