| NPI | 1699350694 |
|---|---|
| Former Name | SHELBY KYAN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NE 2808) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2021-03-11 |
| Last Update Date | 2022-10-05 |