| NPI | 1790439701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: CA 22200760) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 756855) |
| Enumeration Date | 2022-02-08 |
| Last Update Date | 2022-02-08 |