| NPI | 1457618928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MA 76985) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IN 22006132A) |
| 235Z00000X Speech-Language Pathologist, (Licence: CA 26907) | |
| 235Z00000X Speech-Language Pathologist, (Licence: OK 3888) | |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2018-07-18 |