NPI | 1619464625 |
---|---|
Former Name | ELIZABETH MALLORY BUJENOVIC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 235Z00000X) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: ND 235Z00000X) |
Enumeration Date | 2018-04-16 |
Last Update Date | 2022-03-14 |