| NPI | 1184848566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DC SLP000118) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202006254) |
| 235Z00000X Speech-Language Pathologist, (Licence: CA 11387) | |
| 235Z00000X Speech-Language Pathologist, (Licence: MD 05536) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2011-06-06 |