| NPI | 1467606103 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41ys00448800) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 106318) |
| Enumeration Date | 2008-11-07 |
| Last Update Date | 2010-12-01 |