NPI | 1255083655 |
---|---|
Former Name | SARAH KUBICEK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 5730) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WI 5730) |
Enumeration Date | 2022-01-26 |
Last Update Date | 2024-01-09 |