| NPI | 1013524719 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225A00000X Music Therapist (Licence: AZ 3009524) |
| Additional Taxonomies | 103TR0400X Psychologist, Rehabilitation |
| 106S00000X Behavior Technician | |
| 163WP0000X Registered Nurse, Pain Management (Licence: AZ 3009524) | |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2020-09-26 |