| NPI | 1942828934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, |
| Additional Taxonomies | 222Q00000X Developmental Therapist |
| 225CA2400X Rehabilitation Counselor, Assistive Technology Practitioner | |
| Enumeration Date | 2020-07-07 |
| Last Update Date | 2023-08-04 |