| NPI | 1295912624 |
|---|---|
| Former Name | BETHANY ANNE HAVER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MI 4704244961) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704244961) |
| Enumeration Date | 2008-01-29 |
| Last Update Date | 2022-07-29 |