| NPI | 1699014704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NH 724) |
| Additional Taxonomies | 221700000X Art Therapist (Licence: NH 724) |
| 225600000X Dance Therapist (Licence: NH 724) | |
| Enumeration Date | 2013-02-08 |
| Last Update Date | 2013-02-08 |