| NPI | 1447508072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKATERINA KEIFER Member 319-321-5794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: IL 071.008402) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |