| NPI | 1679156608 |
|---|---|
| Former Name | MCKENNA COLLIER SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: OR PA223194) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: UT 13768000-1206) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2021-04-28 |
| Last Update Date | 2025-03-17 |