NPI | 1700860707 |
---|---|
Former Name | ERICA NICOLE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: MA 1022361) |
Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: MI 4301074536) |
207V00000X Obstetrics & Gynecology (Licence: IL 036117285) | |
Enumeration Date | 2005-12-02 |
Last Update Date | 2025-05-09 |