| NPI | 1396850921 |
|---|---|
| Former Name | SARA W DAVIDSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: TN 2183) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: TN 2183) |
| 363A00000X Physician Assistant (Licence: IL 085001498) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2018-03-17 |