| NPI | 1679795926 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00281300) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 008122-1) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2010-10-29 |