| NPI | 1538551817 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TN 243) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 9008654) |
| Enumeration Date | 2015-02-24 |
| Last Update Date | 2023-08-02 |