NPI | 1366645715 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 3959) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA9172) |
Enumeration Date | 2007-06-05 |
Last Update Date | 2019-04-17 |