| NPI | 1811337868 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: SC 587) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SA4465) |
| Enumeration Date | 2013-07-04 |
| Last Update Date | 2024-08-28 |