| NPI | 1154824498 |
|---|---|
| Former Name | SAMANTHA E PARKS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5010487) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024175952) |
| Enumeration Date | 2018-03-13 |
| Last Update Date | 2018-05-09 |