| NPI | 1275317273 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM SAH-2025-0006) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NM SLPCF23037) |
| Enumeration Date | 2023-08-21 |
| Last Update Date | 2025-02-07 |