NPI | 1548628738 |
---|---|
Former Name | SAMANTHA OVERTON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NV PA0548) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: TX PA10363) |
363A00000X Physician Assistant (Licence: CO PA.0004886) | |
363A00000X Physician Assistant | |
Enumeration Date | 2016-02-03 |
Last Update Date | 2022-04-28 |