| NPI | 1548707698 |
|---|---|
| Former Name | SALLIE BLADES ELLIOTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-07064) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2024-05-14 |