| NPI | 1861969701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX 89467) |
| Additional Taxonomies | 225CA2500X Rehabilitation Counselor, Assistive Technology Supplier (Licence: TX 89467) |
| 247200000X Technician, Other (Licence: TX 89467) | |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2022-02-28 |