NPI | 1659605061 |
---|---|
Former Name | DOLLY MARIE RAIHL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: KS 12-00400) |
Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: MO 2012014962) |
Enumeration Date | 2009-10-01 |
Last Update Date | 2014-07-06 |