NPI | 1881178655 |
---|---|
Former Name | SIERRA BURT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: UT 10977713-1206) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: UT 10977713-1206) |
Enumeration Date | 2018-09-18 |
Last Update Date | 2024-11-13 |