| NPI | 1710162060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA9979) |
| Enumeration Date | 2008-01-07 |
| Last Update Date | 2019-12-30 |