| NPI | 1861505513 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 237700000X Hearing Instrument Specialist (Licence: CO CO HAD #80) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2012-11-20 |