NPI | 1780711226 |
---|---|
Former Name | SAMANTHA SUZANNE KOENIG |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: AZ AP2199) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2199) |
Enumeration Date | 2007-02-28 |
Last Update Date | 2022-07-01 |