| NPI | 1477191955 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MD 08991) |
| Enumeration Date | 2019-12-16 |
| Last Update Date | 2020-10-25 |