| NPI | 1407241490 |
|---|---|
| Former Name | MARTHA SICKING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant Surgical (Licence: OR PA172159) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR 172159) |
| Enumeration Date | 2015-04-06 |
| Last Update Date | 2016-08-15 |