NPI | 1386805679 |
---|---|
Former Name | TERESA JEAN BURGEI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208000000X Pediatrics (Licence: OH 35.096729) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MI 4301092613) |
Enumeration Date | 2008-06-19 |
Last Update Date | 2011-03-23 |