| NPI | 1235532938 |
|---|---|
| Former Name | SARAH SLACK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5014394) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704311738) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA RN2266518) | |
| Enumeration Date | 2014-10-08 |
| Last Update Date | 2021-06-10 |