| NPI | 1053804468 |
|---|---|
| Former Name | AUTUMN D SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: KS 04-42883) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KS 94-09488) |
| Enumeration Date | 2018-06-11 |
| Last Update Date | 2020-01-22 |