| NPI | 1336379106 |
|---|---|
| Former Name | TRACY CAROLE WATSON WANG |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-01893) |
| Additional Taxonomies | 224Y00000X Clinical Exercise Physiologist |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2023-03-03 |