| NPI | 1306529672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 214630) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO 14034815) |
| Enumeration Date | 2023-08-11 |
| Last Update Date | 2023-08-11 |