NPI | 1942737903 |
---|---|
Former Name | MEGHAN JANE SMITH |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 4009) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: NC 0010-07581) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2017-05-20 |
Last Update Date | 2021-09-13 |