| NPI | 1740818954 |
|---|---|
| Former Name | KELSIE MARIE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: IA DO06796) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP61435796) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2024-09-11 |