NPI | 1841528643 |
---|---|
Former Name | TABITHA SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2323614) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 4203) |
Enumeration Date | 2009-12-07 |
Last Update Date | 2018-07-19 |