| NPI | 1013641281 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX 89749) |
| Additional Taxonomies | 247200000X (Licence: TX 89749) |
| Enumeration Date | 2022-07-13 |
| Last Update Date | 2023-02-10 |