Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NI0013X | Independent Medical Examiner | 01-05893 | KS |
NPI | 1376048082 |
---|---|
Provider Name | Dr. Samantha Hague I |
First Address | Cheney, KS 67025-8606 |
Second Address | Cheney, KS 67025-8606 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2018 |
Last Update Date | 30/05/2019 |