| NPI | 1952769358 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: OH 12292) |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, (Licence: OH COND.2015343-SP) |
| Enumeration Date | 2016-02-01 |
| Last Update Date | 2019-05-13 |