Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 2006-00441 | NC |
NPI | 1053375949 |
---|---|
Provider Name | Dr. Lorena Benavides |
First Address | Raleigh, NC 27607-0058 |
Second Address | Raleigh, NC 27607-0058 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 17/08/2016 |