| NPI | 1467933713 |
|---|---|
| Former Name | MARIAH LYNN SANDERBECK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA OA004591) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA060061) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2022-12-14 |