| NPI | 1780757187 |
|---|---|
| Former Name | PETSY ANN ELIZABETH KEPPLE- SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY f332902) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2007-07-08 |