| NPI | 1649519398 |
|---|---|
| Former Name | KIMBERLY ELAINE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 183500000X Pharmacist (Licence: GA 014944) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: SC 12497) |
| 183500000X Pharmacist (Licence: IL 051293340) | |
| Enumeration Date | 2013-01-31 |
| Last Update Date | 2013-01-31 |