| NPI | 1073704847 |
|---|---|
| Former Name | FRANCIS J. FISHBURNE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MD 01022) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: SC 1012) |
| 103G00000X Clinical Neuropsychologist (Licence: VA 0810001099) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-07 |