| NPI | 1831418144 |
|---|---|
| Former Name | STEPHANIE A SPONENBURGH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: FL PA9105963) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: FL PA9105963) |
| 363AM0700X Physician Assistant, Medical (Licence: PA MA054354) | |
| Enumeration Date | 2010-05-26 |
| Last Update Date | 2018-05-14 |