| NPI | 1881929172 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: RI SP00953) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MA SLP100827) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2025-07-01 |