| NPI | 1568091379 |
|---|---|
| Former Name | SALLY HALE GANTT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AL 1550) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AL PA1550) |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2022-01-10 |