NPI | 1851045140 |
---|---|
Former Name | SAMANTHA LUCE |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: OH 50.007387RX) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: IN 10005013A) |
Enumeration Date | 2022-02-07 |
Last Update Date | 2025-09-23 |