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 |