| NPI | 1851670541 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 10295) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: WA SI60182917) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2024-03-12 |