| NPI | 1194023283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 10885) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA10885) |
| Enumeration Date | 2011-03-14 |
| Last Update Date | 2024-02-27 |