| NPI | 1790865434 |
|---|---|
| Former Name | LINETTE JEANNA TIBBEN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2080P0203X Pediatrics, Pediatric Critical Care Medicine (Licence: VA 0102202051) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX S0284) |
| 208D00000X General Practice (Licence: AL DO.1129) | |
| 208D00000X General Practice (Licence: VA 0102202051) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2024-09-24 |