| NPI | 1538165709 |
|---|---|
| Former Name | LAURA ELLEN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN122652) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: GA RN122652) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2017-12-14 |