| NPI | 1457084618 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 120132) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2022-07-06 |
| Last Update Date | 2022-12-07 |