NPI | 1790807659 |
---|---|
Former Name | JULIE CLARE SCHRECK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080S0010X Pediatrics, Sports Medicine (Licence: CO 0052807) |
Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: OH 35095723) |
Enumeration Date | 2007-04-04 |
Last Update Date | 2021-04-12 |