| NPI | 1639565591 |
|---|---|
| Former Name | DEMETRIA JOY SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RX0202X Internal Medicine, Medical Oncology (Licence: GA 92402) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S2903) |
| 207RX0202X Internal Medicine, Medical Oncology (Licence: TX S2903) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX S2903) | |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2022-08-26 |