| NPI | 1992343248 |
|---|---|
| Former Name | MARYANNE SMITH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209020414) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: IL 209.020414) |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2024-10-15 |