NPI | 1184110298 |
---|---|
Professional Name | JORDAN LYNNE WALTERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 4896) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
Enumeration Date | 2018-07-02 |
Last Update Date | 2022-11-18 |