| NPI | 1891026498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM SAH-2023-0038) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MS S4401) |
| Enumeration Date | 2010-01-21 |
| Last Update Date | 2025-04-03 |