| NPI | 1841523776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA R SMITH Apn 618-939-7771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: IL 209007742) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |