| NPI | 1124470745 |
|---|---|
| Former Name | AMANDA WHEATLEY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: MN 1084) |
| Additional Taxonomies | 213ES0103X Podiatrist Foot & Ankle Surgery (Licence: IL 135000923) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2021-09-13 |