NPI | 1316468200 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 028202) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2017-06-29 |
Last Update Date | 2019-04-18 |