NPI | 1760617518 |
---|---|
Former Name | REBECCA ROSE HAUGEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 213E00000X Podiatrist (Licence: MI 5901002467) |
Additional Taxonomies | 213E00000X Podiatrist (Licence: PA sc006287) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2009-05-22 |
Last Update Date | 2018-03-17 |