www.neurocriticalcare.org
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Submission Tags: falconsandbox
Submission: On June 25 via api from US — Scanned from DE
Submission Tags: falconsandbox
Submission: On June 25 via api from US — Scanned from DE
Form analysis 1 forms found in the DOM
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