| NPI | 1598706558 |
|---|---|
| Former Name | MICHELLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: TX N4069) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G86967) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2016-03-24 |