| NPI | 1962933085 |
|---|---|
| Former Name | CANDACE RENEE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MI O540108734754) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2017-03-21 |