| NPI | 1427353283 |
|---|---|
| Former Name | SELENA LEE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-170904) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: AL 1-170904) |
| 363LF0000X Nurse Practitioner, Family (Licence: MS R865284) | |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2025-04-08 |