| NPI | 1144893231 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 221700000X Art Therapist (Licence: NY 002232-1) |
| Additional Taxonomies | 225A00000X Music Therapist (Licence: NY 12880) |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2021-07-19 |