NPI | 1326300567 |
---|---|
Former Name | SARA DEVITT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NY 015632-1) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 015632-1) |
363AS0400X Physician Assistant, Surgical (Licence: NY 01563201) | |
Enumeration Date | 2012-06-13 |
Last Update Date | 2018-06-21 |