NPI | 1467489807 |
---|---|
Former Name | TINA M SCHRADER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: IL 036094764) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036094764) |
Enumeration Date | 2006-06-28 |
Last Update Date | 2020-05-20 |