| NPI | 1619520442 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 4381) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA LL60965361) |
| Enumeration Date | 2019-07-21 |
| Last Update Date | 2019-07-21 |