| NPI | 1134789340 |
|---|---|
| Former Name | TAYLOR LILAMIA TESORO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901400442) |
| Additional Taxonomies | 213E00000X Podiatrist (Licence: MI 5951001228) |
| Enumeration Date | 2019-06-19 |
| Last Update Date | 2022-10-27 |