| NPI | 1700385952 |
|---|---|
| Former Name | SAMANTHA TERESA JANUS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CO PA.0008288) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10003892A) |
| 363AS0400X Physician Assistant, Surgical (Licence: TX PA11474) | |
| Enumeration Date | 2018-02-02 |
| Last Update Date | 2024-01-17 |