| NPI | 1730643719 |
|---|---|
| Former Name | MICHELE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2020004946) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MO 2013010064) |
| 163W00000X Registered Nurse (Licence: KS 14132335032) | |
| Enumeration Date | 2019-01-24 |
| Last Update Date | 2021-08-25 |