| NPI | 1205249778 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 19093) |
| Additional Taxonomies | 261QH0700X Clinic/Center, Hearing and Speech (Licence: CA 19093) |
| 171R00000X Interpreter (Licence: CA CCHI # 001656) | |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2024-04-29 |