| NPI | 1396633889 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: FL SI8074) |
| Additional Taxonomies | 171W00000X Contractor |
| Enumeration Date | 2025-06-25 |
| Last Update Date | 2025-09-25 |