| NPI | 1134383037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146004552) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 14004552) |
| Enumeration Date | 2008-07-10 |
| Last Update Date | 2008-07-10 |