| NPI | 1801136783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CA SP 20390) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: CA 20390) |
| Enumeration Date | 2013-02-28 |
| Last Update Date | 2023-04-14 |