| NPI | 1699192856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID EDWARD HANSEN Owner 918-712-9004 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: OK 849) |
| Enumeration Date | 2014-03-26 |
| Last Update Date | 2014-03-26 |