NPI | 1255635801 |
---|---|
Former Name | SARA ELIZABETH PERRY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA PA57540) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: TX PA07257) |
Enumeration Date | 2010-12-22 |
Last Update Date | 2023-08-02 |