| NPI | 1568134070 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC012049) |
| Additional Taxonomies | 225A00000X Music Therapist |
| Enumeration Date | 2021-10-03 |
| Last Update Date | 2021-10-03 |