| NPI | 1538205851 |
|---|---|
| Former Name | TRACY LYNNE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7357) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD C01254) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2022-12-27 |