| NPI | 1538549464 |
|---|---|
| Former Name | SARAH MODAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 61443) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2015-06-05 |
| Last Update Date | 2021-09-20 |