| NPI | 1689197519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WD0400X Registered Nurse Diabetes Educator (Licence: LA RN136488) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN136488) |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2022-07-21 |