| NPI | 1437676244 | 
|---|---|
| Other Name | EJUAN DAVIS SMALLWOOD | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management | 
| Additional Taxonomies | 174400000X Specialist | 
| 246Z00000X Specialist/Technologist, Other | |
| Enumeration Date | 2017-08-23 | 
| Last Update Date | 2022-07-21 |