| NPI | 1699464206 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA SI61326553) |
| Enumeration Date | 2023-05-01 |
| Last Update Date | 2023-05-01 |