| NPI | 1467908483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NE 1994) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NE 551) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2017-07-31 |