| NPI | 1356624738 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: 44298) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor Assistive Technology Practitioner (Licence: ATP 44298) |
| 225CA2500X Rehabilitation Counselor Assistive Technology Supplier (Licence: ATP 44298) | |
| Enumeration Date | 2011-09-22 |
| Last Update Date | 2013-09-05 |