| NPI | 1346636529 |
|---|---|
| Former Name | ELYSE PAIGE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: SC 87077) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: NC 2018-00844) |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 209560) | |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2022-09-07 |