| NPI | 1699785956 |
|---|---|
| Former Name | KIRSTEN ANN MOORE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 213ES0131X Podiatrist Foot Surgery (Licence: WI 788025) |
| Additional Taxonomies | 213ES0131X Podiatrist Foot Surgery (Licence: MN 616) |
| Enumeration Date | 2006-08-09 |
| Last Update Date | 2023-07-31 |