NPI | 1922656362 |
---|---|
Former Name | SARA CORK |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10909) |
Additional Taxonomies | 363A00000X Physician Assistant |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2019-08-29 |
Last Update Date | 2022-04-05 |