| NPI | 1326314428 |
|---|---|
| Professional Name | SHANAN ZICKEFOOSE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: 1132) |
| Additional Taxonomies | 246ZA2600X Specialist/Technologist, Other, Art, Medical (Licence: OK 1132) |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2022-10-22 |