| NPI | 1518380237 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 22-3-0) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IA 002420) |
| Enumeration Date | 2014-01-31 |
| Last Update Date | 2025-05-30 |