NPI | 1952834368 |
---|---|
Former Name | BRENNA ASHLEY BENSON |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: AZ 67710) |
Additional Taxonomies | 208000000X Pediatrics (Licence: UT 10955741-1205) |
Enumeration Date | 2017-04-04 |
Last Update Date | 2023-08-15 |