NPI | 1801046909 |
---|---|
Former Name | SARA CAMPBELL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA053614) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA06222) |
363A00000X Physician Assistant (Licence: PA OA004770) | |
Enumeration Date | 2008-09-25 |
Last Update Date | 2019-09-12 |