NPI | 1972050649 |
---|---|
Former Name | SAMANTHA RAUCHWERGER |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 020169) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CT 3695) |
Enumeration Date | 2016-09-09 |
Last Update Date | 2023-10-17 |