| NPI | 1427141068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID SLP-1785) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: UT 374126-4102) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2016-12-20 |