| NPI | 1114235082 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 107814) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NM C-4680) |
| Enumeration Date | 2010-09-14 |
| Last Update Date | 2025-08-28 |