| NPI | 1184075897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15623) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ7591) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2020-02-25 |