| NPI | 1861743999 |
|---|---|
| Former Name | SAMANTHA MARIE KOLASA |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: NC 0010-04547) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-04547) |
| Enumeration Date | 2012-09-28 |
| Last Update Date | 2020-10-22 |