| NPI | 1871229674 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH SP.15067) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND20211871dp) |
| Enumeration Date | 2022-07-26 |
| Last Update Date | 2023-05-02 |