| NPI | 1407495591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: AZ SLPA12216) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: AZ SLPA12216) |
| Enumeration Date | 2020-01-06 |
| Last Update Date | 2024-12-09 |