| NPI | 1164313623 |
|---|---|
| Former Name | SAMANTHA PAIGE BONGO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: NY 812016-01) |
| Enumeration Date | 2025-07-14 |
| Last Update Date | 2025-10-01 |