| NPI | 1962818567 |
|---|---|
| Former Name | ELIZABETH ANNE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TN 1501) |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |