NPI | 1538767041 |
---|---|
Former Name | SAMANTHA JO BOLIGNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: IN 28222223A) |
Enumeration Date | 2020-10-16 |
Last Update Date | 2020-10-16 |