| NPI | 1346673100 |
|---|---|
| Former Name | SAMANTHA PAIGE FORD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: IA 002419) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MN 1964) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2019-12-19 |