| NPI | 1104268614 |
|---|---|
| Former Name | CRYSTAL BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: OH 35.150023) |
| Additional Taxonomies | 207RC0200X Internal Medicine, Critical Care Medicine (Licence: MN 61000) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2024-06-25 |