| NPI | 1033228663 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 7815) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA7242) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2008-01-24 |