| NPI | 1841871787 |
|---|---|
| Former Name | SAMANTHA LYN INNIS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207SG0201X Medical Genetics, Clinical Genetics (M.D.) (Licence: PA MT233907) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX V2705) |
| Enumeration Date | 2021-04-20 |
| Last Update Date | 2025-09-08 |