| NPI | 1568536027 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist (Licence: NM SLP2673) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist (Licence: NM 2673) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2022-03-21 |