| NPI | 1003384363 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner |
| Enumeration Date | 2018-11-05 |
| Last Update Date | 2026-10-12 |