| NPI | 1235822594 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ12316) |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: FL SI5340) |
| Enumeration Date | 2023-06-01 |
| Last Update Date | 2025-06-11 |