| 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 | 2024-06-14 |