| NPI | 1427026988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146012446) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NC 6417) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2015-11-19 |