NPI | 1639468135 |
---|---|
Former Name | JENNIFER LUKAC |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: MO 2014007663) |
Additional Taxonomies | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: MO 2014007663) |
Enumeration Date | 2011-04-05 |
Last Update Date | 2021-05-04 |