| NPI | 1437674454 |
|---|---|
| Former Name | SAMMY LANE RADCLIFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2017028760) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MO 2017028760) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2024-12-18 |