| NPI | 1841824695 |
|---|---|
| Former Name | SAMANTHA JENAE MARTIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 238475) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 238475) |
| Enumeration Date | 2020-03-01 |
| Last Update Date | 2021-06-03 |