| NPI | 1770952780 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS01131900) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 016540) |
| Enumeration Date | 2015-09-20 |
| Last Update Date | 2024-06-28 |