| NPI | 1013484393 |
|---|---|
| Former Name | SAMANTHA KEGERRIES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2018017649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018017649) |
| Enumeration Date | 2018-10-25 |
| Last Update Date | 2024-02-05 |