| NPI | 1487964631 |
|---|---|
| Former Name | KEISHA SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 331233-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NJ 26NJ00289600) |
| Enumeration Date | 2010-10-20 |
| Last Update Date | 2015-07-17 |