NPI | 1831322965 |
---|---|
Former Name | CORPIA CHANTLE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 036-129521) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.056055) |
207R00000X Internal Medicine (Licence: IN 01072345A) | |
Enumeration Date | 2009-08-24 |
Last Update Date | 2020-05-28 |