NPI | 1427310861 |
---|---|
Former Name | ELISABETH RHACHAEL BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant |
Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
Enumeration Date | 2012-06-12 |
Last Update Date | 2016-09-07 |