NPI | 1649402785 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 19686) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 017508) |
Enumeration Date | 2009-08-21 |
Last Update Date | 2022-07-21 |