| NPI | 1659535664 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41ys00539500) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 016491) |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2008-07-18 |