NPI | 1730699109 |
---|---|
Former Name | SAMANTHA K BLUEFARB |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.005278RX) |
Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: OH 50.005278RX) |
Enumeration Date | 2017-10-11 |
Last Update Date | 2020-09-16 |