| NPI | 1851055909 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NJ 41YS01009300) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: NY 029597-01) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2021-10-25 |