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 |