| NPI | 1497583595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SD 1295-SLP) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 101266) |
| Enumeration Date | 2024-07-22 |
| Last Update Date | 2024-07-22 |