NPI | 1376051888 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: NY 028341) |
Additional Taxonomies | 222Q00000X Developmental Therapist |
Enumeration Date | 2018-01-18 |
Last Update Date | 2022-07-21 |