| NPI | 1518917319 |
|---|---|
| Former Name | SARA MARIE WISKOW |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09521) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA055572) |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2022-10-09 |