| NPI | 1659032985 | 
|---|---|
| Other Name | DIDDY DEAR | 
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1065937) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 1065937) | 
| 163WC0200X Registered Nurse, Critical Care Medicine (Licence: TX 1065937) | |
| 183700000X Pharmacy Technician (Licence: TX 292904) | |
| Enumeration Date | 2022-01-08 | 
| Last Update Date | 2025-08-25 |