| NPI | 1013923457 |
|---|---|
| Former Name | MARY BETH LEAHY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: KS 15-01673) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: NY 007373) |
| 363A00000X Physician Assistant (Licence: MO 2014005142) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2015-01-12 |