| NPI | 1366417305 |
|---|---|
| Former Name | KRISTEN ENGLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: WI 63613) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G76696) |
| Enumeration Date | 2006-02-22 |
| Last Update Date | 2020-02-24 |