| NPI | 1184048837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP8778) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA12774) |
| Enumeration Date | 2014-02-14 |
| Last Update Date | 2014-02-14 |