| NPI | 1316353121 |
|---|---|
| Former Name | SAMANTHA PAIGE YATES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MO 2017044296) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110-004588) |
| 363A00000X Physician Assistant | |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2019-09-24 |