NPI | 1457785040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA13067) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ6296) |
Enumeration Date | 2013-08-30 |
Last Update Date | 2021-12-14 |