NPI | 1053565861 |
---|---|
Former Name | SARA LYNNE BOYLE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 2300) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MN 103577) |
Enumeration Date | 2008-11-06 |
Last Update Date | 2017-02-03 |