NPI | 1073851598 |
---|---|
Former Name | BETTY A BRALEY |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: WV 01696) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2013-01-17 |
Last Update Date | 2024-04-16 |