| NPI | 1801229794 |
|---|---|
| Former Name | JACLYN SUZETTE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA NP23254) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 23254) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2014-08-01 |