NPI | 1932810751 |
---|---|
Former Name | BLAKE BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IN 28205992A) |
Additional Taxonomies | 207RC0000X Internal Medicine, Cardiovascular Disease (Licence: IN 28205992A) |
Enumeration Date | 2022-12-13 |
Last Update Date | 2023-02-15 |