| NPI | 1033577275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 026094) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA16099) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2021-11-08 |