NPI | 1548807985 |
---|---|
Former Name | SARAH HICKS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: KY PA2606) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: KY PA2606) |
363AM0700X Physician Assistant, Medical (Licence: KY PA2606) | |
Enumeration Date | 2019-12-04 |
Last Update Date | 2020-06-04 |