| NPI | 1033362017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 018430-1) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 018430) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2023-02-17 |