NPI | 1225290265 |
---|---|
Former Name | SARAH ELIZABETH DODGE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 11029) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IA 001906) |
Enumeration Date | 2008-07-01 |
Last Update Date | 2013-05-16 |