NPI | 1417445636 |
---|---|
Former Name | SUZANNE MICHELLE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: MD D0099379) |
Additional Taxonomies | 208600000X Surgery (Licence: AZ R76671) |
Enumeration Date | 2018-04-24 |
Last Update Date | 2024-04-15 |