| NPI | 1053640037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WD0400X Registered Nurse Diabetes Educator (Licence: ID N-31902) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N-31902) |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2009-12-21 |