| NPI | 1750751863 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP-23606) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: HI SP-850) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2025-08-06 |