| NPI | 1952368342 |
|---|---|
| Former Name | JODY LIN TRUESDALE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: PA MA001689L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA001689L) |
| 363AM0700X Physician Assistant, Medical (Licence: PA OA000187L) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2022-09-28 |