| NPI | 1033442710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 019100) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 4929) |
| Enumeration Date | 2009-09-11 |
| Last Update Date | 2009-09-11 |