| NPI | 1003581455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: TX 91528) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor Assistive Technology Practitioner (Licence: TX 91528) |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2021-11-24 |