| NPI | 1518588813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 221700000X Art Therapist (Licence: NM CAT0208121) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: NY 002152) |
| Enumeration Date | 2020-04-28 |
| Last Update Date | 2022-11-17 |