NPI | 1881035640 |
---|---|
Former Name | THERESA KOEBERL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 2080P0208X Pediatrics, Pediatric Infectious Diseases (Licence: MN 59743) |
Additional Taxonomies | 208000000X Pediatrics (Licence: MN 59743) |
Enumeration Date | 2013-07-09 |
Last Update Date | 2020-08-18 |