| NPI | 1720792575 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA 29324) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: DC SLP1001418) |
| 235Z00000X Speech-Language Pathologist, (Licence: CA 1834075) | |
| Enumeration Date | 2023-01-06 |
| Last Update Date | 2023-01-06 |