| NPI | 1821587478 |
|---|---|
| Former Name | SARA RAE KING |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NM PA2023-0045) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2018-05-08 |
| Last Update Date | 2024-04-15 |