NPI | 1891957924 |
---|---|
Former Name | CAROLYN SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX R9813) |
Additional Taxonomies | 207P00000X Emergency Medicine (Licence: VA 0101252861) |
207R00000X Internal Medicine (Licence: NE 5842) | |
Enumeration Date | 2008-06-30 |
Last Update Date | 2020-06-26 |