| NPI | 1336431725 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: TX 105383) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: MD 14036197) |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2011-05-04 |