| NPI | 1073751756 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: NY 526929) |
| Additional Taxonomies | 163WH0200X Registered Nurse, Home Health (Licence: NY 526929) |
| 163WS0200X Registered Nurse, School (Licence: NY 526929) | |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2009-02-11 |