| NPI | 1003101601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier |
| Enumeration Date | 2011-06-13 |
| Last Update Date | 2023-01-12 |