| NPI | 1164758181 |
|---|---|
| Former Name | SARA ANDERSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: IA 111859) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MT 587) |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2023-01-17 |