| NPI | 1336413392 |
|---|---|
| Former Name | MARIE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75707-022) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2012007177) |
| Enumeration Date | 2012-03-08 |
| Last Update Date | 2024-02-04 |