| NPI | 1033599220 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 11796) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: 0) |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2016-03-18 |