| NPI | 1063828390 |
|---|---|
| Former Name | SARA EILEEN JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: IN 01097195A) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2014-07-08 |
| Last Update Date | 2025-09-25 |