| NPI | 1588910772 |
|---|---|
| Former Name | KERIANN MICHELLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NY 015742) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NJ 25MP00373300) |
| Enumeration Date | 2012-07-25 |
| Last Update Date | 2023-03-07 |