| NPI | 1427300565 |
|---|---|
| Former Name | SARAH RENEE SEVERANCE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: WA 60316579) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WA PA60316579) |
| Enumeration Date | 2012-10-14 |
| Last Update Date | 2016-06-29 |