NPI | 1942769575 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: NM SLPA6942) |
Additional Taxonomies | 106S00000X Behavior Technician |
Enumeration Date | 2019-03-13 |
Last Update Date | 2019-10-10 |