| NPI | 1437779782 | 
|---|---|
| Former Name | SAMANTHA DIBAISE | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: NE 9560) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2020-04-16 | 
| Last Update Date | 2023-06-28 |