| NPI | 1497142996 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: RI RN47992) |
| Additional Taxonomies | 163WC0400X Registered Nurse, Case Management (Licence: RI RN47992) |
| 163W00000X Registered Nurse (Licence: RI RN47992) | |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2015-09-30 |