| NPI | 1366498131 |
|---|---|
| Former Name | LISA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: MI 4301080102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 4301080102) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2025-07-14 |