NPI | 1093978892 |
---|---|
Former Name | SHELLY RAE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered (Licence: IL 041-273477) |
Enumeration Date | 2008-07-02 |
Last Update Date | 2008-10-23 |