| NPI | 1841564663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163WD0400X Registered Nurse, Diabetes Educator (Licence: NY 20810014) |
| Additional Taxonomies | 174H00000X Health Educator (Licence: NY 453485-1) |
| Enumeration Date | 2012-02-24 |
| Last Update Date | 2025-02-24 |