NPI | 1164718946 |
---|---|
Former Name | SAMANTHA A RICHARDS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MA055399) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 540) |
Enumeration Date | 2011-06-21 |
Last Update Date | 2021-12-16 |