| NPI | 1598429003 |
|---|---|
| Former Name | SALLY ALEEN HART |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 4211) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2021-10-30 |
| Last Update Date | 2022-02-24 |