NPI | 1740595354 |
---|---|
Former Name | ERICA LYN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CO PA.0003011) |
Enumeration Date | 2010-08-09 |
Last Update Date | 2024-09-22 |