| NPI | 1346282506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL009085) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA 7349) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-02-05 |