| NPI | 1962840223 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: TX 64039) |
| Additional Taxonomies | 247200000X Technician, Other |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner | |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2023-11-20 |