| NPI | 1679727564 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00587200) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 018749) |
| Enumeration Date | 2008-11-05 |
| Last Update Date | 2012-02-01 |