NPI | 1851597199 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: DE O1-0001767) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: VA 2202004207) |
Enumeration Date | 2007-06-25 |
Last Update Date | 2023-07-03 |