| NPI | 1336460922 |
|---|---|
| Former Name | JENNIFER ELIZABETH SAMPLES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: FL ME162888) |
| Additional Taxonomies | 208600000X Surgery (Licence: NC 2018-01719) |
| Enumeration Date | 2010-06-17 |
| Last Update Date | 2023-06-12 |