NPI | 1285412668 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 163WG0000X Registered Nurse, General Practice (Licence: CA 813605) |
Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: CA 813605) |
163WP2201X Registered Nurse, Ambulatory Care (Licence: CA 813605) | |
Enumeration Date | 2023-09-18 |
Last Update Date | 2023-09-18 |