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 |