NPI | 1952799660 |
---|---|
Other Name | ABBY BENNETT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: NC 0010-13845) |
Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer (Licence: NC LAT-2808) |
2255A2300X Specialist/Technologist, Athletic Trainer (Licence: TX AT5646) | |
Enumeration Date | 2015-01-03 |
Last Update Date | 2024-01-22 |