NPI | 1194228767 |
---|---|
Former Name | SARAH STEPHENS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 9239) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1334) |
Enumeration Date | 2018-03-09 |
Last Update Date | 2020-08-18 |