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Individual
INDRA SMITH
Active
Individual
INDRA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
738534
NY
Other
Enumeration date
05/07/2017
Last updated
02/20/2018
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