| NPI | 1114409331 |
|---|---|
| Former Name | SAMANTHA CAROL JOHNSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QH0002X Family Medicine, Hospice and Palliative Medicine (Licence: OK 97587) |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |