| NPI | 1871151837 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: WI 4798) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IN 22009018A) |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2026-04-15 |