| NPI | 1306227301 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 027571) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA14175) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2020-11-24 |