| NPI | 1174905657 |
|---|---|
| Former Name | MARILYN BEATTY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: NJ 25MP00371600) |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical (Licence: PA MA057625) |
| Enumeration Date | 2015-06-22 |
| Last Update Date | 2021-12-23 |