| NPI | 1457365892 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: FL 2843752) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: FL CDE #2222-0025) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2007-12-13 |