| NPI | 1891315255 |
|---|---|
| Former Name | TAYLOR MICHELLE BENNETT |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NC 2023-00368) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: NC 261915) |
| Enumeration Date | 2020-04-25 |
| Last Update Date | 2023-03-05 |