| NPI | 1518507193 |
|---|---|
| Former Name | SAMANTHA LEE DERRINGER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: KY 3014150) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 3014150) |
| Enumeration Date | 2020-01-10 |
| Last Update Date | 2022-05-20 |