| NPI | 1427566595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146014278) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 242.004529) |
| Enumeration Date | 2018-01-11 |
| Last Update Date | 2022-09-25 |