| NPI | 1083113427 |
|---|---|
| Former Name | SAMANTHA L. CANNELL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: SC 2935) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: SC 2935) |
| Enumeration Date | 2018-02-11 |
| Last Update Date | 2023-09-19 |