| NPI | 1851725956 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX ATP67219) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX ATP67219) |
| 225CX0006X (Licence: TX ATP67219) | |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2013-08-26 |