| 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 |