| NPI | 1730649997 |
|---|---|
| Former Name | TESSA MARIE BENANZER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.144754) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30000) |
| 207R00000X Internal Medicine (Licence: MN 67710) | |
| Enumeration Date | 2019-03-23 |
| Last Update Date | 2022-07-14 |