NPI | 1740731801 |
---|---|
Former Name | SARA ANN LYNN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA058675) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA058675) |
363AM0700X Physician Assistant, Medical (Licence: PA OA003963) | |
Enumeration Date | 2016-10-24 |
Last Update Date | 2022-03-31 |