NPI | 1588141188 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DE 0001680) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: PA SL014531) |
Enumeration Date | 2018-07-26 |
Last Update Date | 2025-06-08 |