| NPI | 1861606246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMAS REFUGIO GRANADOS Owner 505-797-0810 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: NM 702) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: NM 702) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2009-07-07 |