| NPI | 1306320429 |
|---|---|
| Former Name | SARA MARIE WICK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 022520) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 22520) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2023-06-30 |