| NPI | 1811241136 |
|---|---|
| Former Name | JENNIFER LAUREN SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 10760) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ 5226) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2022-01-02 |