NPI | 1215658885 |
---|---|
Former Name | SAMANTHA MOLLENHAUER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0008849) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2022-09-12 |
Last Update Date | 2025-08-13 |