| NPI | 1902542616 |
|---|---|
| Former Name | FANTASIA SAMANTHA MARIE GARCIA HERNANDEZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: WA RN61172658) |
| Enumeration Date | 2022-05-06 |
| Last Update Date | 2022-05-06 |