| NPI | 1437500758 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103TS0200X Psychologist School (Licence: FL SS1228) |
| Additional Taxonomies | 247200000X Technician, Other (Licence: FL SS 1228) |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2021-04-21 |