| NPI | 1871106575 | 
|---|---|
| Former Name | ELISABETH MARY BRUZEK | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: MN 7090)  | 
| Additional Taxonomies | 103G00000X Clinical Neuropsychologist (Licence: WI 3868)  | 
| Enumeration Date | 2020-08-24 | 
| Last Update Date | 2024-10-23 |