| NPI | 1669342978 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 30003696) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA22949) |
| Enumeration Date | 2025-11-11 |
| Last Update Date | 2025-11-24 |