| NPI | 1689535411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX ATP565) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: TX 565) |
| Enumeration Date | 2025-11-20 |
| Last Update Date | 2026-01-15 |