| NPI | 1326287426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DMITRI BOUGAKOV Sole Proprietor 646-496-8963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NY 017107) |
| Enumeration Date | 2009-02-12 |
| Last Update Date | 2009-02-12 |