| NPI | 1265568505 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP005407) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP 5407) |
| Enumeration Date | 2007-02-23 |
| Last Update Date | 2009-11-02 |