NPI | 1093219339 |
---|---|
Former Name | CHARLOTTE M SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: GA 91215) |
Additional Taxonomies | 207N00000X Dermatology (Licence: GA 9942) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2018-03-21 |
Last Update Date | 2022-07-01 |