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NPI Profile for DYLAN P BENNETT in SHREVEPORT, LA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Critical Care Medicine |
163WC0200X |
| NPI # | 1063240158 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 07/22/2024 | |
| Last updated | 07/22/2024 - More than a year ago | |
| Sole proprietor 1 | Yes | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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DYLAN P BENNETT
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DYLAN P BENNETT