NPI | 1184155939 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 15109) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 7490) |
235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0003295) | |
235Z00000X Speech-Language Pathologist, (Licence: FL SA16347) | |
235Z00000X Speech-Language Pathologist, (Licence: GA 6679) | |
Enumeration Date | 2017-03-23 |
Last Update Date | 2024-07-24 |