| NPI | 1932418340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: MD 08704) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: FL SZ4828) |
| 235Z00000X Speech-Language Pathologist, (Licence: VA 2202010014) | |
| Enumeration Date | 2010-10-03 |
| Last Update Date | 2024-01-02 |