| NPI | 1750833307 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MA RN2341300) |
| Additional Taxonomies | 163WD0400X Registered Nurse, Diabetes Educator (Licence: RI RN53309) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2020-04-13 |