| NPI | 1396435004 |
|---|---|
| Former Name | KIMBERLY MICHELLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 0000000) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |