| NPI | 1609482017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 225A00000X Music Therapist (Licence: GA 15923) |
| Enumeration Date | 2020-09-21 |
| Last Update Date | 2025-10-07 |