| NPI | 1437857950 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ11939) |
| Additional Taxonomies | 106S00000X Behavior Technician |
| Enumeration Date | 2023-02-23 |
| Last Update Date | 2024-09-11 |