Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT293798 | CA |
NPI | 1033680814 |
---|---|
Provider Name | Samantha Rose Kaufman |
First Address | Germantown, MD 20874-2804 |
Second Address | San Francisco, CA 94143-2204 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2018 |
Last Update Date | 05/12/2018 |