| NPI | 1477648111 |
|---|---|
| Former Name | ERIC PHILLIP JOHNSON |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist (Licence: KS 1387) |
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: KS 1387) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2008-08-26 |