| 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 |