| NPI | 1174586218 |
|---|---|
| Former Name | SUSAN M SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2085R0001X (Licence: KS 04-24196) |
| Additional Taxonomies | 2085R0001X (Licence: MO 102512) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2015-04-21 |