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Individual
WENDY EDA SHAW DAHL
Active
Individual
WENDY EDA SHAW DAHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT26044
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PT26044
LICENSE
CA
Enumeration date
02/23/2007
Last updated
07/08/2007
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