| NPI | 1750872933 |
|---|---|
| Former Name | SAMANTHA ADA TATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: PA MD481368) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT215245) |
| 207W00000X Ophthalmology (Licence: NC 2022-00691) | |
| Enumeration Date | 2018-05-23 |
| Last Update Date | 2023-08-01 |