| NPI | 1003910183 |
|---|---|
| Former Name | SANDRA VICTORIA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA R067932) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: GA R067932) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2008-08-05 |