NPI | 1114348737 |
---|---|
Other Name | BENJAMIN C GRANT |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: MI 5601006899) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: AR PA-1155) |
Enumeration Date | 2013-12-27 |
Last Update Date | 2023-06-05 |