| NPI | 1447513999 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2355S0801X Specialist/Technologist, Speech-Language Assistant (Licence: NY 790B) |
| Additional Taxonomies | 174400000X Specialist (Licence: NY 790B) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |