NPI | 1346863495 |
---|---|
Former Name | ALYSSA MARIE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NC 5014582) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2020-05-23 |
Last Update Date | 2021-08-24 |