| NPI | 1033515440 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH sp-11775) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH 2014212) |
| Enumeration Date | 2014-11-12 |
| Last Update Date | 2017-03-23 |