| NPI | 1477418903 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: ID 8271975) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA SLPI.SI.70029034) |
| Enumeration Date | 2025-12-17 |
| Last Update Date | 2025-12-17 |