| NPI | 1376164681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: SC 7203) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2024-02-14 |