| NPI | 1245293463 |
|---|---|
| Former Name | BEVERLY ANN FRYE-FREEMAN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: WI 225-023) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 8905) |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2010-07-07 |