| NPI | 1376875047 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255R0406X Specialist/Technologist, Rehabilitation, Blind (Licence: AZ 5205) |
| Additional Taxonomies | 174400000X Specialist (Licence: AZ 5205) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2023-05-16 |