NPI | 1457334468 |
---|---|
Former Name | ANGELA MARIE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WI 44207-20) |
Additional Taxonomies | 208000000X Pediatrics (Licence: WI 44207020) |
208000000X Pediatrics (Licence: IA 42431) | |
Enumeration Date | 2005-11-23 |
Last Update Date | 2022-07-03 |