NPI | 1851717664 |
---|---|
Former Name | EMILY ANNE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TX PA09189) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
363AS0400X Physician Assistant, Surgical (Licence: TX PA09189) | |
Enumeration Date | 2014-03-17 |
Last Update Date | 2019-03-18 |