| 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 |