| NPI | 1508446303 |
|---|---|
| Former Name | SALLY ANN STATHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: CA A184490) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2024-05-13 |