| NPI | 1821506536 |
|---|---|
| Former Name | SAMANTHA CISNEROS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA PA55326) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2018-01-16 |
| Last Update Date | 2021-01-18 |