| NPI | 1669629093 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP18308) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ 5941) |
| Enumeration Date | 2008-08-27 |
| Last Update Date | 2023-01-29 |