| NPI | 1376933630 |
|---|---|
| Former Name | KIM ELIZABETH BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL ARNP 3025202) |
| Enumeration Date | 2015-01-26 |
| Last Update Date | 2015-01-26 |