| NPI | 1790937217 |
|---|---|
| Former Name | SAMANTHA PARK AMATO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: PA MD063556L) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00207500) |
| Enumeration Date | 2008-10-15 |
| Last Update Date | 2019-05-03 |