NPI | 1942783675 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: IL 146015219) |
Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: IL 242004973) |
Enumeration Date | 2018-09-09 |
Last Update Date | 2021-06-03 |