NPI | 1528422516 |
---|---|
Former Name | RODDREA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: IN 01082806A) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
Enumeration Date | 2016-04-06 |
Last Update Date | 2023-11-27 |