NPI | 1205277597 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 231H00000X Audiologist (Licence: LA 648) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: LA 648) |
Enumeration Date | 2013-07-15 |
Last Update Date | 2024-05-06 |