| NPI | 1841426004 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 8524) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 019089) |
| Enumeration Date | 2009-06-02 |
| Last Update Date | 2009-06-02 |