NPI | 1972675387 |
---|---|
Professional Name | MARK SMITH |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: TX 16959) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AZ PA2869) |
363AM0700X Physician Assistant, Medical (Licence: NE 686) | |
Enumeration Date | 2006-11-14 |
Last Update Date | 2024-01-09 |