NPI | 1609467216 |
---|---|
Former Name | SARAH ELIZABETH IREY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OK 3196) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: WY PT1090) |
Enumeration Date | 2021-01-27 |
Last Update Date | 2025-03-28 |