NPI | 1104266758 |
---|---|
Former Name | ASHLEY ANNE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MI 5601006676) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601006676) |
Enumeration Date | 2013-06-27 |
Last Update Date | 2021-12-27 |