| NPI | 1457750234 |
|---|---|
| Former Name | SMANTHA BURNHAM |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP0200X Nurse Practitioner Pediatrics (Licence: VT 101.0134299) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: NY F382385-1) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: NH 088196-23) | |
| Enumeration Date | 2014-08-18 |
| Last Update Date | 2023-10-23 |