| NPI | 1831324433 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: FL SA15131) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 235Z00000X Speech-Language Pathologist, (Licence: MI 7101004036) | |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2020-09-11 |