| NPI | 1720335672 |
|---|---|
| Former Name | TARAH ASHLEY FREEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2023008128) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA61000712) |
| 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: MO 2012018517) | |
| 363A00000X Physician Assistant (Licence: OR PA186969) | |
| Enumeration Date | 2012-08-09 |
| Last Update Date | 2024-04-08 |