| NPI | 1215101340 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225A00000X Music Therapist |
| Enumeration Date | 2008-04-18 |
| Last Update Date | 2023-02-07 |