| NPI | 1013086461 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: RI AUD00050) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: RI SP00012) |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2012-09-12 |