NPI | 1184917528 |
---|---|
Former Name | MELISSA MARIE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: TX P9966) |
Additional Taxonomies | 208000000X Pediatrics (Licence: TX BP1-0040964) |
Enumeration Date | 2011-05-18 |
Last Update Date | 2014-06-29 |