| NPI | 1912081324 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146.003238) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005099) |
| 235Z00000X Speech-Language Pathologist, (Licence: AR SP#2227) | |
| 235Z00000X Speech-Language Pathologist, (Licence: CA SP13298) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IN 22002765A) | |
| Enumeration Date | 2006-10-24 |
| Last Update Date | 2013-05-24 |