| NPI | 1861867707 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 231H00000X Audiologist (Licence: TX 80724) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TX 100132) |
| Enumeration Date | 2015-12-03 |
| Last Update Date | 2023-05-18 |