| NPI | 1457946923 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 021954-01) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CT 004517) |
| Enumeration Date | 2021-03-05 |
| Last Update Date | 2023-01-15 |