NPI | 1013177872 |
---|---|
Former Name | STEPHANIE COLLEEN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: NV 14922) |
Additional Taxonomies | 2084N0400X Psychiatry & Neurology, Neurology (Licence: IA 1252071) |
Enumeration Date | 2008-06-13 |
Last Update Date | 2023-04-02 |