| NPI | 1811556210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CX0006X |
| Additional Taxonomies | 2255R0406X Specialist/Technologist, Rehabilitation, Blind |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner | |
| Enumeration Date | 2019-06-10 |
| Last Update Date | 2019-06-10 |