NPI | 1952021487 |
---|---|
Former Name | DUSTIN GENE BLANKENSHIP |
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: MN 9482) |
Enumeration Date | 2022-09-02 |
Last Update Date | 2022-09-02 |