| NPI | 1104041623 |
|---|---|
| Former Name | SARA CROOKSHANK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 4220-33) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA10005183) |
| 363AS0400X Physician Assistant, Surgical (Licence: OH 50003326) | |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-05-16 |