| NPI | 1760412548 |
|---|---|
| Former Name | CORRIE A GOERGEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: KY 46086) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NY 246114) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-10-19 |