| NPI | 1639450802 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WC1500X Registered Nurse Community Health (Licence: CA 74202) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 731422) |
| 163WD0400X Registered Nurse Diabetes Educator (Licence: CA 731422) | |
| 364SC1501X Clinical Nurse Specialist Community Health/Public Health (Licence: CA 3512) | |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2020-06-12 |