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 |