NPI | 1932765013 |
---|---|
Former Name | REBECCA MICHELLE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: ID PA-1665) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2019-05-14 |
Last Update Date | 2023-12-20 |