NPI | 1033654462 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 10895) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15492) |
Enumeration Date | 2016-12-20 |
Last Update Date | 2024-08-20 |