| NPI | 1477803666 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NV 1402336889) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2013-02-27 |