| NPI | 1215701214 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CX0006X (Licence: NY 1387267) |
| Additional Taxonomies | 2255R0406X Specialist/Technologist, Rehabilitation, Blind (Licence: NY 1387267) |
| Enumeration Date | 2023-11-09 |
| Last Update Date | 2023-11-09 |