| NPI | 1114081221 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC006307) |
| Additional Taxonomies | 225A00000X Music Therapist |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2013-11-01 |