| NPI | 1669845392 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.006564) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA SP 20740) |
| 235Z00000X Speech-Language Pathologist, (Licence: MO 0325431) | |
| Enumeration Date | 2015-11-03 |
| Last Update Date | 2015-11-03 |