| NPI | 1659194017 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 16826) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 33167) |
| Enumeration Date | 2024-11-05 |
| Last Update Date | 2024-11-05 |