| NPI | 1891135117 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NC 11365) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: TN 4814) |
| Enumeration Date | 2013-07-01 |
| Last Update Date | 2015-07-08 |