NPI | 1548831167 |
---|---|
Former Name | SARA EVANS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9114657) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA062490) |
Enumeration Date | 2021-07-06 |
Last Update Date | 2023-09-12 |