| NPI | 1730411802 |
|---|---|
| Former Name | KERRIE MICHELLE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MD C0009854) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: VA 0110005556) |
| Enumeration Date | 2010-02-01 |
| Last Update Date | 2025-06-11 |