| NPI | 1245620897 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IN 22005152A) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.9169) |
| 235Z00000X Speech-Language Pathologist, (Licence: KY 3844) | |
| Enumeration Date | 2015-02-03 |
| Last Update Date | 2015-02-03 |