| NPI | 1215200654 |
|---|---|
| Former Name | SAMANTHA ALYSSA THOMAS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CT 004957) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 337171) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 004957) | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2022-09-09 |