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 |