| NPI | 1154066793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: AZ rn156222) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: AZ rn156222) |
| 163WI0500X Registered Nurse, Infusion Therapy (Licence: AZ rn156222) | |
| Enumeration Date | 2022-04-28 |
| Last Update Date | 2022-04-28 |