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 |