| NPI | 1942973912 |
|---|---|
| Former Name | ELAINE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: CT 14759) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 14503) |
| Enumeration Date | 2021-07-27 |
| Last Update Date | 2026-05-14 |