| NPI | 1699393819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 225CA2500X Rehabilitation Counselor Assistive Technology Supplier |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2020-07-15 |