NPI | 1639548076 |
---|---|
Former Name | SAMANTHA ANN SPONSKI |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: VA 0024172852) |
Enumeration Date | 2015-09-16 |
Last Update Date | 2015-09-21 |