Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT296992 | CA |
NPI | 1013534825 |
---|---|
Provider Name | Mrs. Katrina Marie Slosman |
First Address | Fresno, CA 93720-4685 |
Second Address | Fresno, CA 93722-8401 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2020 |
Last Update Date | 26/06/2020 |