NPI | 1871282368 |
---|---|
Former Name | SAMANTHA JO SCHROEDER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0073755) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CO 1871282368) |
Enumeration Date | 2023-05-02 |
Last Update Date | 2024-10-06 |