| NPI | 1144471228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.15111) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 05850) |
| Enumeration Date | 2008-10-07 |
| Last Update Date | 2022-09-06 |