NPI | 1235336744 |
---|---|
Former Name | DENISE CORAL SMYTH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208D00000X General Practice (Licence: PA MD456007) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: WV 23331) |
207Q00000X Family Medicine (Licence: WV 23331) | |
Enumeration Date | 2007-06-28 |
Last Update Date | 2021-03-24 |