NPI | 1881346062 |
---|---|
Former Name | SAMANTHA GRARD |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 030134) |
Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology (Licence: NY 863634) |
Enumeration Date | 2022-01-19 |
Last Update Date | 2023-09-10 |