NPI | 1417346156 |
---|---|
Former Name | SARA ELIZABETH MULLINAX |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 12062) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TN 4761) |
363AS0400X Physician Assistant, Surgical (Licence: TN 4761) | |
Enumeration Date | 2015-01-19 |
Last Update Date | 2024-01-06 |