NPI | 1154652477 |
---|---|
Former Name | SARAH KATHRYN BOLES |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: AK 102588) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: KY PA1211) |
363A00000X Physician Assistant (Licence: NY 014239) | |
Enumeration Date | 2010-01-26 |
Last Update Date | 2015-12-10 |