| NPI | 1154760312 |
|---|---|
| Former Name | SAMANTHA ANN FUGATE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: MI 5101020751) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2018-06-25 |