| NPI | 1891985339 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: KS 2075) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: MO 117641) |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2007-07-31 |