| NPI | 1851614101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner |
| Additional Taxonomies | 373H00000X Day Training/Habilitation Specialist |
| 101Y00000X Counselor | |
| Enumeration Date | 2010-03-01 |
| Last Update Date | 2025-05-21 |