| NPI | 1538928510 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP36828) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CO PSLP.0001061) |
| 235Z00000X Speech-Language Pathologist, (Licence: AK 213553) | |
| Enumeration Date | 2024-03-13 |
| Last Update Date | 2024-03-13 |