| NPI | 1275852642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146012075) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA SP-9083-SL) |
| Enumeration Date | 2010-05-25 |
| Last Update Date | 2026-08-17 |