| NPI | 1548405038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: NM R40513) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NM R40513) |
| Enumeration Date | 2008-12-11 |
| Last Update Date | 2008-12-11 |