NPI | 1083065379 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 10671) |
Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: 3392) |
Enumeration Date | 2016-06-28 |
Last Update Date | 2023-11-08 |