| NPI | 1487106043 |
|---|---|
| Former Name | KATHRYN SAMUEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: VT 055-0031319) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: VT 055.0031319) |
| Enumeration Date | 2016-10-31 |
| Last Update Date | 2021-12-23 |