| NPI | 1184067704 |
|---|---|
| Former Name | SAMANTHA GAYLE BLOCK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: FL ME131698) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: FL ME131698) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2022-04-25 |