| NPI | 1184053258 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX ATP 52501) |
| Enumeration Date | 2013-11-08 |
| Last Update Date | 2024-04-18 |