NPI | 1902326945 |
---|---|
Former Name | SAMANTHA L LICHTNER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-11855) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005843) |
363AM0700X Physician Assistant, Medical | |
Enumeration Date | 2017-06-21 |
Last Update Date | 2024-08-13 |