| NPI | 1053824334 |
|---|---|
| Former Name | SANDRA LOREN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11010433) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 23453) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2024-08-23 |