| NPI | 1558849513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO SLP.0003284) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA22589) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2024-06-28 |