| NPI | 1508319443 |
|---|---|
| Former Name | SAMANTHA GIBSON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.006107RX) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: PA MA058293) |
| 363A00000X Physician Assistant (Licence: PA OA003820) | |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2022-11-28 |