| NPI | 1538547682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: SC 36021) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 36021) |
| Enumeration Date | 2015-05-09 |
| Last Update Date | 2019-02-28 |