| NPI | 1538505482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other (Licence: TX ATP62519) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX ATP62519) |
| Enumeration Date | 2013-05-20 |
| Last Update Date | 2024-06-10 |