| NPI | 1649444068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 103979) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 9707) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2008-04-16 |