| NPI | 1285343038 |
|---|---|
| Former Name | SAMANTHA FAY DEYO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: WI 13078) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: WI 220932) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-12-06 |