NPI | 1154786614 |
---|---|
Former Name | DAWN RENAE SMAIL |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201805045NP-PP) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 4332) |
Enumeration Date | 2015-12-28 |
Last Update Date | 2022-12-20 |