| 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 |