| NPI | 1184989634 |
|---|---|
| Former Name | TESSA CAITLIN BEITZEL |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: MT 57605) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: WV 574) |
| 363AM0700X Physician Assistant, Medical (Licence: NM PA2013-0093) | |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2023-11-27 |