NPI | 1043435779 |
---|---|
Former Name | TERESA ELLEN VANDENBERGH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MI 4301099708) |
Additional Taxonomies | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: WI 52893) |
Enumeration Date | 2007-04-16 |
Last Update Date | 2021-02-25 |