| NPI | 1023413705 |
|---|---|
| Former Name | CANDACE JEAN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CO PA.0004132) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2014-10-24 |
| Last Update Date | 2021-03-20 |