| NPI | 1447787429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2400X Rehabilitation Counselor Assistive Technology Practitioner (Licence: 87109) |
| Additional Taxonomies | 226300000X Kinesiotherapist (Licence: IL 1888) |
| 247200000X Technician, Other | |
| Enumeration Date | 2017-05-22 |
| Last Update Date | 2025-04-01 |