NPI | 1063918340 |
---|---|
Former Name | DANIELLE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TN 0000063315) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2018-04-04 |
Last Update Date | 2021-07-01 |