| NPI | 1457704793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 2255R0406X Specialist/Technologist, Rehabilitation, Blind |
| Enumeration Date | 2016-07-21 |
| Last Update Date | 2018-03-17 |