NPI | 1689195414 |
---|---|
Former Name | HEIDI LYNN THRAMER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: OR PA184479) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: 2000001491) |
Enumeration Date | 2017-07-01 |
Last Update Date | 2024-01-11 |