| NPI | 1033542386 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP8382) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: AZ SLPA8382) |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2024-08-23 |