NPI | 1730491895 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 105891) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 18114) |
Enumeration Date | 2010-07-06 |
Last Update Date | 2010-07-06 |