NPI | 1013268218 |
---|---|
Other Name | SAMANTHA LYNN WHALEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MA PA5512) |
Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: CT 2833) |
363AS0400X Physician Assistant, Surgical (Licence: MA PA5512) | |
Enumeration Date | 2012-09-27 |
Last Update Date | 2024-07-01 |