| NPI | 1366093486 |
|---|---|
| Former Name | SAMANTHA JO DAVIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: CA 95012816) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: CA 95012816) |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |