| NPI | 1366052649 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: AR 201069) |
| Enumeration Date | 2020-08-03 |
| Last Update Date | 2021-01-25 |