| NPI | 1295986347 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CX0006X |
| Additional Taxonomies | 2255R0406X Specialist/Technologist, Rehabilitation, Blind (Licence: OR 10367109) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2008-10-07 |