| NPI | 1134315831 |
|---|---|
| Former Name | BETHANY A. DE JOSEPH |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00237100) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MD Pending) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2020-12-18 |