| NPI | 1841588761 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: TX 106116) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP007671) |
| 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS00675000) | |
| 235Z00000X Speech-Language Pathologist, (Licence: LA 8012) | |
| 235Z00000X Speech-Language Pathologist, (Licence: MD 09260) | |
| 235Z00000X Speech-Language Pathologist, (Licence: WA LL60686608) | |
| 235Z00000X Speech-Language Pathologist, (Licence: CA 23548) | |
| 235Z00000X Speech-Language Pathologist, (Licence: NY 16882) | |
| 235Z00000X Speech-Language Pathologist, (Licence: NY 022453-1) | |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2020-02-20 |