| NPI | 1275972788 |
|---|---|
| Former Name | SARAH ANNE WAGNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA061505) |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2022-07-29 |