NPI | 1235722380 |
---|---|
Former Name | SARAH REAGAN TEPOOL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: AL PA.1738) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA.1738) |
Enumeration Date | 2021-02-18 |
Last Update Date | 2021-11-16 |