| NPI | 1114180957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse Diabetes Educator (Licence: IL 041230782) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: IL CDE #2021-0497) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2008-07-07 |