| NPI | 1003290933 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255R0406X Specialist/Technologist, Rehabilitation, Blind |
| Additional Taxonomies | 225CX0006X Rehabilitation Counselor, Orientation and Mobility Training Provider |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2015-07-09 |