| NPI | 1184295636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ10447) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant |
| Enumeration Date | 2021-07-06 |
| Last Update Date | 2021-10-05 |