| NPI | 1396155818 |
|---|---|
| Former Name | JORDAN LEIGH SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 1501792) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: GA 7164) |
| Enumeration Date | 2014-05-06 |
| Last Update Date | 2015-06-17 |