| NPI | 1528384658 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146006740) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IN 22004828A) |
| Enumeration Date | 2010-04-14 |
| Last Update Date | 2010-04-14 |