NPI | 1265437594 |
---|---|
Former Name | TAMARA KAY SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CO DR.0062664) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD421711) |
Enumeration Date | 2005-06-14 |
Last Update Date | 2019-08-26 |