NPI | 1730294612 |
---|---|
Former Name | SAMANTHA AMANDA CRAWFORD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0000776) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: MN 13880) |
Enumeration Date | 2006-08-20 |
Last Update Date | 2023-07-11 |