| NPI | 1518452358 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 221700000X Art Therapist (Licence: KY 277267) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: KY 242773) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2022-05-12 |