| NPI | 1306228788 |
|---|---|
| Former Name | COURTNEY SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NH 1964) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: AL 1023) |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2023-02-03 |