| NPI | 1134939614 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier (Licence: OK 93735) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2025-01-08 |
| Last Update Date | 2025-01-15 |