| NPI | 1295024719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other (Licence: ATP 4124) |
| Additional Taxonomies | 225CA2500X Rehabilitation Counselor Assistive Technology Supplier (Licence: ATP 4124) |
| Enumeration Date | 2011-04-05 |
| Last Update Date | 2011-04-27 |