| NPI | 1326814088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202011203) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: DC SLP200001545) |
| Enumeration Date | 2023-12-04 |
| Last Update Date | 2024-01-07 |