NPI | 1750786059 |
---|---|
Former Name | SARAH HUCKEBY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 2626) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: SC 2988) |
363AS0400X Physician Assistant, Surgical (Licence: TN 2626) | |
Enumeration Date | 2014-10-29 |
Last Update Date | 2021-07-27 |