| NPI | 1912427816 |
|---|---|
| Former Name | AMANDA MICHELLE BENAVIDES |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: IA MD-47809) |
| Enumeration Date | 2017-06-21 |
| Last Update Date | 2024-12-05 |