NPI | 1093246951 |
---|---|
Former Name | HEIDI MICHELLE WEESE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: IA 105141) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2017-03-22 |
Last Update Date | 2024-04-12 |