| NPI | 1841590866 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OR 12851) |
| Additional Taxonomies | 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner |
| Enumeration Date | 2010-10-25 |
| Last Update Date | 2015-11-01 |