| NPI | 1730403031 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225C00000X Rehabilitation Counselor (Licence: N/A) |
| Additional Taxonomies | 225CX0006X Rehabilitation Counselor Orientation and Mobility Training Provider |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2010-03-16 |