NPI | 1093260481 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: DE O1-0001676) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: GA SLP009365) |
Enumeration Date | 2016-08-16 |
Last Update Date | 2019-06-14 |