| NPI | 1225710700 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL017920) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: HI SP-2245-0) |
| Enumeration Date | 2023-08-03 |
| Last Update Date | 2024-10-10 |