| NPI | 1821309816 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist |
| Additional Taxonomies | 227900000X Respiratory Therapist, Registered |
| Enumeration Date | 2010-06-24 |
| Last Update Date | 2010-06-24 |