NPI | 1801118765 |
---|---|
Former Name | SAMANTHA HUME |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 308938) |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA054195) |
363AS0400X Physician Assistant, Surgical (Licence: NJ 25MP00385200) | |
Enumeration Date | 2010-02-19 |
Last Update Date | 2022-06-24 |