NPI | 1588988042 |
---|---|
Former Name | AMY MARIE BENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: WA MD60355949) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
208000000X Pediatrics (Licence: WA ML 60157913) | |
Enumeration Date | 2010-03-26 |
Last Update Date | 2013-04-12 |