| NPI | 1831405638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: RI SP01263) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA 7545) |
| Enumeration Date | 2010-08-31 |
| Last Update Date | 2015-10-19 |