| NPI | 1063664126 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 017971) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202009605) |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2024-10-28 |