| NPI | 1669789061 |
|---|---|
| Former Name | SARA LYN NELSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 005926) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363AM0700X Physician Assistant, Medical (Licence: GA 5926) | |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2020-12-07 |