| NPI | 1174186670 |
|---|---|
| Former Name | SAMANTHA SHOLEH KORDEIE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: AZ 225016) |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-07-30 |