| NPI | 1831230556 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: CO 00001574) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 106253) |
| 235Z00000X Speech-Language Pathologist, (Licence: WA LL00003425) | |
| 235Z00000X Speech-Language Pathologist, (Licence: AZ SLP5666) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2023-09-22 |