| NPI | 1205188117 |
|---|---|
| Former Name | JESSICA ELIZABETH SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: 127877) |
| Additional Taxonomies | 156FX1101X Technician/Technologist, Ophthalmic Assistant (Licence: 197849) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |