NPI | 1558029470 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.014124) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
Enumeration Date | 2021-12-08 |
Last Update Date | 2021-12-08 |