| NPI | 1427367069 |
|---|---|
| Former Name | SHAUNDA LANE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: TX PA09870) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: ZZ PAT9105640) |
| Enumeration Date | 2010-09-30 |
| Last Update Date | 2015-09-15 |