| NPI | 1285182444 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00867600) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 9866) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2016-09-16 |