Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 152350 | MA |
NPI | 1447482427 |
---|---|
Provider Name | Mark E Courtney |
First Address | Boston, MA 02215-5501 |
Second Address | Boston, MA 02215-5501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/08/2009 |
Last Update Date | 10/08/2009 |