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 |