| NPI | 1659727758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225CX0006X Rehabilitation Counselor, Orientation and Mobility Training Provider |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner |
| Enumeration Date | 2016-05-06 |
| Last Update Date | 2016-05-06 |