| NPI | 1326271784 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MO 2010031406) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 2009023789) |
| Enumeration Date | 2009-09-01 |
| Last Update Date | 2016-10-24 |