| NPI | 1730555178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 183500000X Pharmacist (Licence: MO 2015020506) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: MO 2015020506) |
| 174H00000X Health Educator (Licence: MO 2015020506) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2024-09-10 |