| NPI | 1528209129 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: IL 2061-0302) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: ID N31309) |
| Enumeration Date | 2009-03-12 |
| Last Update Date | 2009-03-12 |