Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 54450 | WI |
N | 111NI0900X | Internist | 54450 | WI |
Y | 207RG0100X | Gastroenterologist | 54450 | WI |
NPI | 1043483936 |
---|---|
Provider Name | Padmavathi Mali |
First Address | La Crosse, WI 54601-5429 |
Second Address | La Crosse, WI 54601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2008 |
Last Update Date | 05/08/2019 |