Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | A37841 | CA |
NPI | 1396281606 |
---|---|
Provider Name | Prof. Moyra Smith |
First Address | Irvine, CA 92697-0001 |
Second Address | Orange, CA 92868-4482 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2017 |
Last Update Date | 10/01/2017 |