| NPI | 1972887503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other (Licence: TX 1972887503) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner (Licence: TX ATP48380) |
| Enumeration Date | 2011-09-30 |
| Last Update Date | 2026-02-03 |