| NPI | 1528290335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: CA LSP3037) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: FL SA9466) |
| Enumeration Date | 2009-08-12 |
| Last Update Date | 2009-08-12 |