NPI | 1932758596 |
---|---|
Former Name | SAMANTHA MEGAN SANDERS |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95013284) |
Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK F09190278) |
Enumeration Date | 2019-09-06 |
Last Update Date | 2021-11-30 |