NPI | 1689991697 |
---|---|
Former Name | ANDREA DENISE RETTGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: NY 280903) |
Additional Taxonomies | 208000000X Pediatrics (Licence: IN 01072560A) |
Enumeration Date | 2010-04-29 |
Last Update Date | 2021-03-09 |