NPI | 1912041484 |
---|---|
Former Name | FARIBA EBRAHIM KHAN KHEZEL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 103G00000X Clinical Neuropsychologist (Licence: CA PSY20295) |
Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY20295) |
103TC0700X Psychologist, Clinical (Licence: CA PSY20295) | |
Enumeration Date | 2007-02-17 |
Last Update Date | 2010-12-02 |