| NPI | 1396211355 |
|---|---|
| Former Name | SARAH RENEE GREDER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 12534468-1206) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WY PA794) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2022-04-12 |