| NPI | 1811273089 |
|---|---|
| Former Name | SAMANTHA ROBYN GEBOFF |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363AM0700X Physician Assistant Medical (Licence: PA MA055018) |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical (Licence: DE C5-0000785) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2022-07-21 |