NPI | 1043990492 |
---|---|
Former Name | STEPHANIE MANUEL SAMAR |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: PA SP027943) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: PA RN643391) |
Enumeration Date | 2023-07-20 |
Last Update Date | 2023-08-15 |