| NPI | 1043877384 |
|---|---|
| Former Name | SAMANTHA MARIE WALL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA12869) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: TX 193400000X) |
| Enumeration Date | 2019-05-22 |
| Last Update Date | 2023-05-30 |