| NPI | 1851107320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: AZ 23163) |
| Additional Taxonomies | 225CX0006X (Licence: AZ 21656) |
| Enumeration Date | 2024-12-09 |
| Last Update Date | 2024-12-09 |