NPI | 1386998482 |
---|---|
Former Name | KALIE EILEEN SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2342) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IL 085.007492) |
Enumeration Date | 2012-10-29 |
Last Update Date | 2023-10-25 |