| NPI | 1942632559 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NY 024323-1) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2019-06-04 |