| NPI | 1184945115 |
|---|---|
| Former Name | JODY LEEANN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: TX Q8794) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2010-06-14 |
| Last Update Date | 2019-04-25 |