| NPI | 1336435718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 221700000X Art Therapist (Licence: NM 303490) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM 303490) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2011-07-11 |