| NPI | 1598263758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: RI 72253) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: RI SP00399-P) |
| Enumeration Date | 2018-01-23 |
| Last Update Date | 2018-01-23 |