| NPI | 1265817084 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 225600000X Dance Therapist (Licence: R-DMT-2456) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2020-07-20 |