| 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 |