NPI | 1730339631 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA13310) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP6263) |
235Z00000X Speech-Language Pathologist, (Licence: AK 121) | |
235Z00000X Speech-Language Pathologist, (Licence: NC 11095) | |
235Z00000X Speech-Language Pathologist, (Licence: ID SLP-3163) | |
235Z00000X Speech-Language Pathologist, (Licence: TX 105253) | |
Enumeration Date | 2008-09-26 |
Last Update Date | 2023-08-11 |