| NPI | 1750347043 |
|---|---|
| Former Name | VANESSA LYNN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: MN 12386) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WA PA60342141) |
| 363A00000X Physician Assistant (Licence: WI 4246) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-11-30 |