| NPI | 1629257407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225A00000X Music Therapist (Licence: PA 06200) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC015237) |
| Enumeration Date | 2007-10-30 |
| Last Update Date | 2023-01-29 |