| NPI | 1174015499 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 32521) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: CA 3499) |
| Enumeration Date | 2018-06-01 |
| Last Update Date | 2023-08-30 |