| NPI | 1558676171 |
|---|---|
| Former Name | JACKAI ALEXIS SIOBHAN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 20996) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: OR PA154862) |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2018-03-17 |