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 |