NPI | 1063995314 |
---|---|
Former Name | SARA BRADY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WI 4691) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA 60870890) |
Enumeration Date | 2018-09-12 |
Last Update Date | 2022-03-21 |