| NPI | 1396318234 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: PA SL012883) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 08360) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |