NPI | 1326298175 |
---|---|
Former Name | SUSAN LYNN BENZ |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 140697) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: AZ 005109) |
Enumeration Date | 2008-09-29 |
Last Update Date | 2022-01-13 |